Pix'n'Mix Phase 3A (3) Flashcards
Clinical features of carpal tunnel
Tingling Numbness Worse at night Pain radiating down wrist Thenar muscle atrophy Thumb adduction
List the contra indications of doing a lumbar puncture
Platelet less than 50 x 10(9) Respiratory distress Shock Seizures Reduced consciousness
Outline the mode of action of SSRI’s
Blockade of the reuptake of serotonin
Acts predominantly at the prefrontal cortex
List the cancers which metastasise to the bone
Bronchus
Thyroid
Kidney
Prostate
List the two endocrine agents used in breast cancer and where they target
Oestrogen receptor: Tamoxifen
HER2 receptor: Herceptin
List the most common type of breast cancer
Adenoma
Treatment of ? meningitis in the community
Benzylpenicillin (IV/IM)
List the triad seen in Wernickles encapathlopathy
Intranuclear opthamolplegia
Ataxia
Confusion
List the symptoms of delirium tremens
Clouding of consciousness Liluputian hallucinations Disorientation Amnesia Psychomotor retardation
Rx with Benzos
Outline the key features of Juvenile myoclonic epilepsy
Onset adolescent
Seizures are myoclonic
Shortly after waking
Tiredness can increase the number of seizures
List the predisposing of CHARGE
Coloboma of the eye Heart defects Atresia of the choanae Retardation of growth Genital abnormalties Ear abnormalties L
List the predisposing features seen in NEC
IUGR PDA Preterm Polycthmia Aphyxia Early rapid enthral feeding
Key features seen on X-ray for
- osteosacroma
- edwings sacroma
Osteosarcoma: sunburst appearance
Edwings sacroma: onion skin
List the features of androgen insensitivity syndrome
46 X,Y No response to testosterone Structures don't develop Regression of the malarian inhibit factors NOT A GIRL OR A BOY
Clinical test used to diagnosis developmental dysplasia of the hips
Barloms
Ortalami
Keys signs of abuse in a child
Torn frenulum labi superiourus
Scalds
Ligature marks
Outline the investigations that you would do in suspected MG
Tensilons test
Ach receptor abs
Nerve conduction studies
Ct for a thymoa
Features of mitral stenosis
Low volume pulse AF Raised JVP Undisplaced apex beat mid diastolic murmur
What does the median nerve supply
"LOAF" Lateral lumbricals Opponenes pollices Abductor pollicis Flexor pollicis brevis
What does the AMT consist of
Recall and address Date of birth Recognition of two people Place Year Name of monarch Name of prime minister Date WW2 ended Count backwards from 20
What type of anaemia is typically seen in alcoholics
Macrocytic anaemia
List the features of corticobasal syndrome
Presents as an asymmetrical cortical syndrome Gait unsteadiness Parkinsonism Aprexia Alien limb syndrome
List the features of cerebellar lesions
Dsdiodochokinesia Ataxoa Nystagmus Intentions tremor Slurred speech Hypotonia
Sign of phenytoin toxicity
Cerebellar syndrome
What are the features of an argil robertson pupil and what causes it
Pupil accommodates but does not react
Caused by syphillis
Name the hallucination commonly seen in coke addicts
Formications
Risk factors for suicide
Male Middle aged Depressed Previous attempt Substance abuse Chronic disease Organised plan No social support Self harm
Antidote to benzodiazapines
Give flumazeine
Define folie á deux
Shared delusional disorder where 2 codependent people develop a paired delusion
Causes of delirium
Degenerative disease Epilepsy Liver failure Intracranial injury Rheumatic chorea Uraemia Infection Metabolic
Management of hypercalcaemia of malignancy
Ca > 3mmol/L
Rehydrate with 4-6L of normal saline over 24hrs
Once rehydrated
- IV pamidronate or zoledronic acid
Monitor fluid status and serum calcium
Side effect of memantine
Hallucinations
Emergency management of APH
MILD
- Set IV infusion
- HB, cross match, grp and save
- Obs
- Locate placenta
- placenta prevue stay in hospital until >37wks
- minor abruption can go home if foetus not in distress
SEVERE
- IVI
- Bloods
- Raise legs
- O2/15L
- Fresh ABO/Rh compatible blood
- Cathetise and monitor output
- Deliver promptyl
- Active management of 3rd stage
Emergency management of PPH
- O2 ( intubate if loss of consciousness)
- x2 IV access large bore cannula
- Bloods ( LFT’s clotting)
- Cross match 6 units ( put out haemorrhage alert 222)
- IV fluids
- Catheterise for UO
- Deliver placenta
- Bimanual compression
- Drugs (Syntometrin, ergometrine, oxytocin infusion, misoprostolol, carboprostolol)
- Take to theatre
- Repair tears
- Still bleed
1. Rush ballon
2. B-lynch suture
3. Internal iliac/uterine artery ligation
4. Subtotal/total hysterectomy
